CMS Formulary

Displaying 142411-142420 of 1611142 results.
ID: 142411
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142412
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 762394
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142413
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284592
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142414
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142415
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284593
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142416
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 284595
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142417
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142418
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142419
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 142420
Formulary ID: 00021058
Formulary Version: 15
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0